Sociodemographic factors and uncomplicated pyelonephritis in women aged 15-50 years: a nationwide Swedish cohort register study (1997-2018).

Abstract

OBJECTIVE\nTo study the relationship between sociodemographic factors and pyelonephritis.\n\n\nMETHODS\nA nationwide open cohort study consisting of 2 052\xa0873 women (76.2% Swedish-born) aged 15-50 years was conducted (1997-2018). The outcome was first event of acute uncomplicated pyelonephritis diagnosed in primary health care settings in relation to the sociodemographic factors. Cox regression models were used in the analyses.\n\n\nRESULTS\nThe study identified 40\xa0724 cases. In the fully adjusted model, women from non-western countries had higher risks of pyelonephritis compared to Swedish-born women. Women from Latin America/Caribbean had highest risk (Hazard ratio\u202f=\u202f1.60; 95% CI 1.49-1.72), followed by Eastern Europe (HR\u202f=\u202f1.26; 95% CI 1.21-1.32) and Middle East/North Africa (HR\u202f=\u202f1.25; 95% CI 1.19-1.30). Low education, low income, urban living, and young age were also associated with higher risks of pyelonephritis.\n\n\nCONCLUSION\nThis study presents novel risk factors associated with pyelonephritis. Women from non-western countries and with low socioeconomic status might suffer disproportionately from this serious infection. This might be due to biological predispositions and the fact that immigrant women do not acquire the same level of health or might receive less health care compared to native women, even in the presence of universal health care.